The failure by the government to deliver on its promise to provide clean, piped water to all by 2014 is indirectly resulting in hundreds of children dying from diarrhoea.Statistics SA's General Household Survey shows at least 1.9million - other studies put the figure at as high as 4.5million - people still do not have access to regular piped water.A report by researcher David Hemson, published in the SA Health Review, indicates that places with the highest number of people who have no access to piped water are those with the highest number of children under the age of five dying from diarrhoea.The study shows that two of the top 10 places with the highest number of child deaths fall within the government's National Health Insurance pilot district projects, the hospitals and clinics of which should be benefiting from increased cash and resource allocations.The areas are OR Tambo in Eastern Cape, where 173 children out of 1000died, and Gert Sibande in Mpumalanga, where 54 out of 1000 died, in the 2014-2015 financial year.Census 2011 figures show nearly 51% of OR Tambo residents do not have access to piped water.In Gert Sibande about 95% of residents have access to piped water but the high death rate is likely to be linked to poor healthcare and treatment facilities.University of Western Cape Emeritus Professor of Public Health David Sanders said diarrhoea was caused by poor hygiene.For example, when there is no water available to wash hands after using the toilet, people handle food that can become infected with bacteria, which is then consumed."People with less water, who must walk miles to find water, will wash their hands less often and are more likely to contaminate food, which can make people sick."Inadequate water has been worsened by the drought.But if children get diarrhoea, it is not a given that they will die.In Cape Town the number of diarrhoea cases has risen year on year, but deaths have dropped, says Sanders. This is because every clinic has the means to rehydrate children so mothers do not have to travel far to a hospital.Water Affairs Department spokesman Sputnik Ratau said the department was aware of the problem of a lack of piped water for all and had a plan to fix it.The department was working with local municipalities and water boards, he said...